MEDICARE: ANTHONY STEVEN BEARD RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LD44	OH

General Provider Information

NPI Number	:	1881217966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY STEVEN BEARD RDN

Provider Business Mailing Address
First Line	:	13 CROYDEN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-1008
Country	:	US
Telephone Number	:	216-965-6264
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 CROYDEN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-1008
Country	:	US
Telephone Number	:	216-965-6264
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2020
Last Update Date	:	05/22/2020

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